Provider Demographics
NPI:1710969050
Name:SEETHARAMAN, KALA (MD)
Entity Type:Individual
Prefix:
First Name:KALA
Middle Name:
Last Name:SEETHARAMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 SUMMER ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-1216
Mailing Address - Country:US
Mailing Address - Phone:508-363-5519
Mailing Address - Fax:508-363-7164
Practice Address - Street 1:115 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-6358
Practice Address - Country:US
Practice Address - Phone:508-383-1000
Practice Address - Fax:508-383-8584
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA76893207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
J16206OtherBLUE SHIELD HMO BLUE
3000054OtherEVERCARE
J16206OtherBLUE CARE ELECT
0116799OtherCIGNA HEALTH PLAN
27052OtherHEALTHY START
5352657OtherAETNA US HEALTHCARE
1061386OtherFIRST HEALTH
9901147OtherFALLON COMMUNITY HEALTH
J16206OtherBLUE SHIELD INDEMNITY
27052OtherCHILDRENS MEDICALSECURITY
784230OtherMVP HEALTH CARE
A20399OtherMEDICARE B
AA2367OtherHARVARD PILGRIM HEALTH
9901147OtherFALLON COMMUNITY HEALTH
1061386OtherFIRST HEALTH